Thyroid Cancer

Staging

o plan the best treatment, your doctor needs to learn the extent (stage) of the disease. Staging is a careful attempt to find out the size of the nodule, whether the cancer has spread, and if so, to what parts of the body.

Thyroid cancer spreads most often to the lymph nodes, lungs, and bones. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original cancer. For example, if thyroid cancer spreads to the lungs, the cancer cells in the lungs are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer. For that reason, it's treated as thyroid cancer, not lung cancer. Doctors call the new tumor "distant" or metastatic disease.

Staging may involve one or more of these tests:

* Ultrasound: An ultrasound exam of your neck may show whether cancer has spread to lymph nodes or other tissues near your thyroid.

* CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside your body. A CT scan may show whether cancer has spread to lymph nodes, other areas in your neck, or your chest.

* MRI: MRI uses a powerful magnet linked to a computer. It makes detailed pictures of tissue. Your doctor can view these pictures on a screen or print them on film. MRI may show whether cancer has spread to lymph nodes or other areas.

* Chest x-ray: X-rays of your chest may show whether cancer has spread to the lungs.

* Whole body scan: You may have a whole body scan to see if cancer has spread from the thyroid to other parts of the body. You get a small amount of a radioactive substance. The substance travels through the bloodstream. Thyroid cancer cells in other organs or the bones take up the substance. Thyroid cancer that has spread may show up on a whole body scan.

Treatment

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.
The choice of treatment depends on:

* the type of thyroid cancer (papillary, follicular, medullary, or anaplastic)
* the size of the nodule
* your age
* whether the cancer has spread

You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor may refer you to a specialist who has experience treating thyroid cancer, or you may ask for a referral. An endocrinologist is a doctor who specializes in treating people who have hormone disorders. You may see a thyroidologist, an endocrinologist who specializes in treating diseases of the thyroid.

You may have a team of specialists. Other specialists who treat thyroid cancer include surgeons, medical oncologists, and radiation oncologists . Your health care team may also include an oncology nurse and a registered dietitian.

Your doctor can describe your treatment choices and the expected results. Thyroid cancer may be treated with surgery, thyroid hormone treatment, radioactive iodine therapy, external radiation therapy, or chemotherapy. Most patients receive a combination of treatments. For example, the standard treatment for papillary cancer is surgery, thyroid hormone treatment, and radioactive iodine therapy. Although external radiation therapy and chemotherapy are not often used, when they are, the treatments may be combined.

Surgery and external radiation therapy are local therapies. They remove or destroy cancer in the thyroid. When thyroid cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.

Thyroid hormone treatment, radioactive iodine therapy, and chemotherapy are systemic therapies. Systemic therapies enter the bloodstream and destroy or control cancer throughout the body.

You may want to know about side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person, and they may change from one treatment session to the next. Before treatment starts, ask you